VARICOSE VEIN TREATMENT IN ACTION

This 45 year old woman had problems with bulging varicose veins for eight years before her friend referred her to our office. She complained that her legs were uncomfortable. She perceived “tightness” in the skin. She felt “pressure” in the upper thighs. After physical exam, venous mapping with ultrasound and Doppler located the problems. Her left and right leg greater saphenous veins were dilated and incompetent, making it difficult for her blood to return to her heart. The valves in her veins were not functioning; gravity would pull the blood down to her feet where it would pool and cause increased pressure, perceived as pressure and tightness.

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The affected leg is being prepped with a bacteriostatic soap. Once the leg is cleaned it is surrounded with sterile drapes.

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Local anesthetic is being prepared. It will be used to anesthetize the small area of skin through which the treatment catheters will be introduced. 

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An ultrasound probe is used to locate and map the vein that is to be treated. 

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Once the skin has been anesthetized and the vein mapped, the ultrasound is used to guide the introducer needle into the vein. Sounds painful, but not really.

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Once the vein has been entered with the introducer catheter (see the orange hub), the thin black radiofrequency (RF) catheter is attached to the RF generator (seen on the little stainless steel cart). The other end is passed through the catheter into the vein.

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Ultrasound is used to follow the catheter up the vein and to verify that the catheter is in the proper position.

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Local anesthetic is infiltrated around the entire length of vein containing the RF catheter. It is delivered by the white pump (seen sitting on the blue RF generator) through a needle under ultrasound guidance.

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Success!

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